By Jessica Graham, M.D., Pediatric Emergency Physician, FMSL Parent and Thomas Hanff, M.D., Heart Failure Cardiologist, FMSL Parent
Pfizer recently performed an mRNA vaccine trial in children aged 5-11. After study results were released, an emergency use authorization (EUA) was approved for children in this age range. However, some parents still have questions or concerns.
*In older children (16-29 years), the incidence of myopericarditis after vaccine is 1 per 5,750. Therefore, it is possible that because even if myopericarditis were going to occur at the same rate in the 5-11 age group, the trial would not pick it up because the total number of children in the trial was less than this.
However:
- Most cases of myopericarditis have occurred between 16-29 years; Rates of myopericarditis after vaccination are much lower in the 12-15 year age group in studies done in Israel and the U.S
- It is hypothesized that the lower dose used in children 5-11 is less likely to cause myocarditis
- In general, the incidence of myocarditis from other causes is lower in this age groupf; myocarditis mostly happens in post-pubertal kids
- Even if it does occur, the cases of myopericarditis have overall been mild and children have recovered well
References
a https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm
b https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/03-COVID-Jefferson-508.pdf
c https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html
d https://secure.jbs.elsevierhealth.com/action/getSharedSiteSession?redirect=https%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flanchi%2Farticle%2FPIIS2352-4642%2821%2900198-X%2Ffulltext&rc=0
e https://publications.aap.org/aapnews/news/17751/FDA-panel-Benefits-of-COVID-19-vaccine-for-ages-5?autologincheck=redirected
f Vaccine-related myocarditis is milder compared to MIS-C (Comparison of MIS-C Related Myocarditis, Classic Viral Myocarditis, and COVID-19 Vaccine related Myocarditis in Children. Trisha Patel, Michael Kelleman, Zachary West, Andrew Peter, Matthew Dove, AreneButto, Matthew E. Oster; medRxiv 2021.10.05.21264581; doi:https://doi.org/10.1101/2021.10.05.21264581)
g https://www.cdc.gov/coronavirus/2019-ncov/vaccines/planning-for-pregnancy.html
h https://publichealth.jhu.edu/2021/the-long-history-of-mrna-vaccines
An evidence review of face masks against COVID-19, Jeremy Howard, Austin Huang, Zhiyuan Li, Zeynep Tufekci, Vladimir Zdimal, Helene-Mari van der Westhuizen, Arne von Delft, Amy Price, Lex Fridman, Lei-Han Tang, Viola Tang, Gregory L. Watson, Christina E. Bax, ReshamaShaikh, Frederik Questier, Danny Hernandez, Larry F. Chu, Christina M.Ramirez, Anne W. Rimoin. Proceedings of the National Academy of Sciences Jan 2021, 118 (4) e2014564118; DOI:10.1073/pnas.2014564118
i https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
j https://publichealth.jhu.edu/2021/the-long-history-of-mrna-vaccines
k https://www.healthline.com/health-news/should-11-year-olds-wait-until-they-are-12-to-get-a-covid-19-vaccine
l https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age